31 May 2018 ¦ Geneva: Tobacco use has declined markedly since 2000, according to a new World Health Organization (WHO) report, but the reduction is insufficient to meet globally agreed targets aimed at protecting people from death and suffering from cardiovascular and other non-communicable diseases (NCDs).

For World No Tobacco Day 2018, WHO has joined with the World Heart Federation to highlight the link between tobacco and cardiovascular diseases (CVD) - the world’s leading causes of death, responsible for 44% of all NCD deaths, or 17.9 million deaths annually.

Tobacco use and second-hand smoke exposure are major causes of cardiovascular diseases, including heart attacks and stroke, contributing to approximately 3 million deaths per year. But evidence reveals a serious lack of knowledge of the multiple health risks associated with tobacco.

“Most people know that using tobacco causes cancer and lung disease, but many people aren’t aware that tobacco also causes heart disease and stroke – the world’s leading killers,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This World No Tobacco Day, WHO is drawing attention to the fact that tobacco doesn’t just cause cancer, it quite literally breaks hearts.”

While many people are aware tobacco use increases the risk of cancer, there are alarming gaps in knowledge of the cardiovascular risks of tobacco use. In many countries, this low awareness is substantial; for example, in China, over 60% of the population is unaware smoking can cause heart attacks, according to the Global Adult Tobacco Survey. In India and Indonesia, more than half of adults do not know smoking can cause stroke.

“Governments have the power in their hands to protect their citizens from suffering needlessly from heart disease,” says Dr Douglas Bettcher, WHO Director for the Prevention of NCDs. “Measures that reduce the risks to heart health posed by tobacco include making all indoor public and workplaces completely smoke-free and promoting use of tobacco package warnings that demonstrate the health risks of tobacco.”

World off track to meet tobacco reduction target Tobacco kills over 7 million people each year, despite the steady reduction in tobacco use globally, as shown in WHO’s new Global Report on Trends in Prevalence of Tobacco Smoking 2000-2025. The report shows that worldwide, 27% smoked tobacco in 2000, compared to 20% in 2016.

However, the pace of action in reducing tobacco demand and related death and disease is lagging behind global and national commitments to reduce tobacco use by 30% by 2025 among people aged 15 and older. If the trend continues on the current trajectory, the world will only achieve a 22% reduction by 2025.

Other main findings from the new report include:

Change in smoking: There are 1.1 billion adult smokers in the world today, and at least 367 million smokeless tobacco users. The number of smokers in the world has barely changed this century: it was also 1.1 billion in 2000. This is due to population growth, even as prevalence rates decline.

By sex: For males aged 15 and over, 43% smoked tobacco in 2000 compared to 34% in 2015. For females, 11% smoked in 2000, compared to 6% in 2015.

Smokeless tobacco: around 6.5% of the global population aged 15 and over use smokeless tobacco (8.4% of males and 4.6% of females).

Country response: Over half of all WHO Member States have reduced demand for tobacco, and almost one in eight are likely to meet the 30% reduction target by 2025. But countries must do more to monitor tobacco use in all its forms – not only tobacco smoking. Currently, one in four countries have insufficient data to monitor their tobacco epidemic.

Youth: Worldwide, about 7%, or just over 24 million children aged 13–15, smoke cigarettes (17 million boys and 7 million girls). About 4% of children aged 13–15 years (13 million) use smokeless tobacco products.

Developing countries: Over 80% of tobacco smokers live in low- and middle-income countries (LMICS). Prevalence of smoking is decreasing more slowly in LMICs than in high-income countries, and the number of smokers is on the increase in low-income countries.

Dr Svetlana Axelrod, WHO’s Assistant Director-General for NCDs and mental health, says: “We know what policies and actions can increase tobacco quit rates, prevent people from starting using tobacco, and reduce demand. We must overcome obstacles to implementing measures like taxation, marketing bans and implementing plain packaging. Our best chance of success is through global unity and strong multisectoral action against the tobacco industry.”

Editors’ note: Countries have committed to reducing premature death from NCDs by one-third by 2030 as part of the Sustainable Development Goals, as well as implementing the WHO Framework Convention on Tobacco Control (WHO FCTC). The WHO FCTC entered into force in February 2005 and has today 181 Parties covering more than 90% of the world's population.